A UK team has reported the second case in the world of HIV-1 remission following CCR5Δ32/Δ32 allogeneic haematopoietic stem-cell transplantation (allo-HSCT).

The case report, published in Nature, comes 10 years after the first such case, known as the 'Berlin Patient', was documented. The latest case has been termed the ‘London Patient’.

The HIV-1-infected adult underwent allo-HSCT for Hodgkin’s lymphoma using cells from a CCR5Δ32/Δ32 donor. Antiretroviral therapy was interrupted 16 months after transplantation. HIV-1 remission has been maintained through a further 18 months.

Plasma HIV-1 RNA has been undetectable, at less than 1 copy per millilitre, along with undetectable HIV-1 DNA in peripheral CD4 T lymphocytes. Quantitative viral outgrowth assay from peripheral CD4 T lymphocytes shows no reactivatable virus using a total of 24 million resting CD4 T cells.

CCR5-tropic, but not CXCR4-tropic viruses were identified in HIV-1 DNA from CD4 T cells of the patient prior to transplant. CD4 T cells isolated from peripheral blood post-transplant did not express CCR5 and were only susceptible to CXCR4-tropic virus ex vivo. HIV-1 Gag-specific CD4 and CD8 T cell responses were lost after transplantation, whereas cytomegalovirus-specific responses were detectable. HIV-1-specific antibodies and avidities fell to levels comparable to those in the Berlin patient following transplantation.

The authors say the data suggest that single allo-HSCT with homozygous CCR5Δ32 donor cells may be sufficient to achieve HIV-1 remission with reduced intensity conditioning and no irradiation.

They add that the findings further support the development of HIV remission strategies based on preventing CCR5 expression.

Only healthcare professionals with a Univadis account have access to this article.

We use cookies in order to provide you with a user-friendly and effective service as well as content adapted to your interests. We also use cookies to dynamically display Univadis ads and ads from our business partners on both Univadis and selected third party websites. To learn more about the cookies on this site, including how to manage them, click here.

Univadis will update its Terms of Use and Privacy Policy on January 12, 2016. Please contact privacy@aptushealth.com if you have any questions about these changes. If you continue to use Univadis after January 12, 2016 the new Terms of Use and Privacy Policy will apply. By your continued use of Univadis, you accept and agree to these terms and policies.